Acute onset dysphagia and neck pain after eating

A woman in her 40s presented to the emergency department late in the evening with dysphagia and discomfort in her throat at the level of the suprasternal notch. Her symptoms had started while she was eating a pork chop for dinner. She was able to swallow saliva and was not drooling, but any attempt to swallow fluids resulted in severe pain and immediate regurgitation. Her airway was assessed and found to be clear; she was able to speak in full sentences, and no change to her voice was discerned. She had no stridor and no difficulty breathing.

Observations on admission were

• Temperature: 37.2°C

• Blood pressure: 131/85 mm Hg

• Pulse rate: 97 beats/min

• Respiratory rate: 17 breaths/min

• Pulse oximetry: 99% on room air.

Nothing remarkable was seen on examination of the patient’s neck and oral cavity. The patient was otherwise fit and well, …